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A comparison of knowledge of diabetes mellitus between patients with diabetes and healthy adults: a survey from north Malaysia

Yun LS, Hassan Y, Aziz NA, Awaisu A, Ghazali R

Patient Educ Couns, 2007 Dec;69(1-3):47-54.
PMID: 17720351 DOI: 10.1016/j.pec.2007.06.017

Objective: The primary objective of this study was to assess and compare the knowledge of diabetes mellitus possessed by patients with diabetes and healthy adult volunteers in Penang, Malaysia.
Method: A cross-sectional study was conducted from 20 February 2006 to 31 March 2006. We randomly selected 120 patients with diabetes mellitus from a diabetic clinic at the General Hospital Penang, Malaysia and 120 healthy adults at a shopping complex in Penang. Each participant was interviewed face-to-face by a pharmacist using a validated questionnaire, and they were required to answer a total of 30 questions concerning knowledge about diabetes mellitus using Yes, No or Unsure as the only response.
Results: The results showed that patients with diabetes mellitus were significantly more knowledgeable than the healthy volunteers about risk factors, symptoms, chronic complications, treatment and self-management, and monitoring parameters. Educational level was the best predictive factor for diabetes mellitus and public awareness.
Conclusion: Knowledge about diabetes mellitus should be improved among the general population.
Practice implications: This study has major implications for the design of an educational programme for diabetics and a health promotion programme as a primary prevention measure for the healthy population in general, and especially for those at high risk. The results could be useful in the design of future studies for evaluating patients' and the general public's knowledge about diabetes mellitus.

Matched MeSH terms: Health Promotion
Fulltext The health beliefs and practice among an institute’s female staff population regarding pap smear, breast self-examination and mammography screening

Aishah Knight, A.S.

Malaysian Journal of Public Health Medicine, 2007;7(2):15-22.
MyJurnal

Cancer screening is an important part of any cancer control program and the success of any screening program is partly dependent on having large numbers of the high risk population availing themselves of the service. The purpose of this study was to assess the cancer screening behavior of fulbtime employed women staff of an institute of higher learning using the Health Belief Model (HBM) construct. The results showed that the rate of reported regular cancer screening behavior (Pap smear screening, breast self examination (BSE), clinical breast examination (CBE) and mammography screening) were low. The rates for regular screening were 42.5% (Pap smear), 20.9% (BSE), 15.5% (CBE) and 9.4% (mammography). There were differences in the dimensions of the HBM between the women who reported regular screening and those that did not. The perceived barriers", "perceived benefits” and “motivation” dimensions were different in Pap smear screening, whereas the "confidence” dimension was different in BSE. Recommendations were made for a health education program targeting both women and men to increase uptake of cancer screening services by women.

Matched MeSH terms: Health Promotion
Fulltext Applicability of the stages of change and Weight Efficacy Lifestyle Questionnaire with natives of Sarawak, Malaysia

Chang CT

Rural Remote Health, 2007 Oct-Dec;7(4):864.
PMID: 18076311

INTRODUCTION: There is an increase in the prevalence of overweight and obesity in Malaysia. Besides prevalence studies, not much is known about either overweight or obese individuals. The objective of this study was to determine the stages of change in losing weight and the self-efficacy in eating control of three indigenous groups of overweight and obese adults in Sarawak, Malaysia.
METHODS: A cross-sectional study was conducted in one rural region in Sarawak using a purposive sample. A structured questionnaire, which included two scales: (1) Weight: Stages of change (SOC) to assess readiness to change; and (2) Weight Efficacy Lifestyle Questionnaire (WEL) (both adopted from the transtheoretical model of change); and a set of pre-tested questionnaires on socio-demographic data, the presence of health problems and self-assessment of weight appropriateness, was used to interview respondents.
RESULTS: The stage distribution for weight loss of these adults respondents (n = 271) showed that 60.5% (n = 164) were in the pre-contemplation stage, 20.7% (n = 56) were in the contemplation stage, 8.5% (n = 23) were in the preparation stage, and 8.9% (n = 24) were in the action stage, while only 1.5% (n = 4) were in the maintenance stage. Except for education, the stage differences were generally stable across age, sex, race, household income, presence or absence of health problem, self-perceived weight and presence of overweight or obesity. Respondents were least able to control their eating under social pressure and food availability, according to their WEL score.
CONCLUSION: A large proportion of the overweight or obese adults was not intending to lose weight. The factor structure of the two WEL original subscales enabled partial differentiation between respondents who were able or unable to resist eating in situations where there were availability of food and experienced physical discomfort. The study results indicate the importance of assessing individuals' SOC score in order to implement stage-matched intervention strategies. More studies should be performed in order to validate the WEL questionnaire for use with a Malaysian sample.

Matched MeSH terms: Health Promotion
Fulltext Dietary modification in a workplace health promotion program in Kuala Lumpur, Malaysia

Moy FM, Ab Sallam A, Wong ML

Asia Pac J Public Health, 2008 Oct;20 Suppl:166-72.
PMID: 19533877

Lifestyle modification is effective in the prevention of cardiovascular diseases. This study aimed to promote healthy lifestyle behaviours to prevent cardiovascular disease. This study was a quasi-experimental trial with a follow up of two years. The intervention group (n = 102) received intensive individual and group counselling on diet and physical activity. The comparison group (n = 84) was given minimal education through mail and group counselling. Following the intervention, both groups reduced their total fat intake through a replacement in carbohydrate intake. The saturated fat and cholesterol intake was also reduced with a larger magnitude in the intervention group. Fruits and vegetables consumption was increased within the intervention group. The intervention group showed a statistically significant reduction in their mean total cholesterol levels with an intervention effect of -0.38 (95% C.I. = -0.63, -0.14) mmol/l. This study has achieved moderate improvement in dietary intakes as well as the total cholesterol of the participants.

Matched MeSH terms: Health Promotion/methods*
Fulltext Linking data to tobacco control program action among students aged 13-15 in Association of Southeast Asian Nations (ASEAN) member states, 2000-2006

Sirichotiratana N, Sovann S, Aditama TY, Krishnan M, Kyaing NN, Miguel-Baquilod M, et al.

Tob Control, 2008 Dec;17(6):372-8.
PMID: 18669557 DOI: 10.1136/tc.2007.024190

The Association of Southeast Asian Nations (ASEAN) has made tobacco use prevention a primary health issue. All ASEAN countries except Indonesia have ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), the world's first public health treaty on tobacco control.

Matched MeSH terms: Health Promotion*
Fulltext What's on Malaysian television? A survey on food advertising targeting children

Karupaiah T, Chinna K, Mee LH, Mei LS, Noor MI

Asia Pac J Clin Nutr, 2008;17(3):483-91.
PMID: 18818170

The Malaysian government recently introduced a ban on fast food advertisements targeting children on television. This study reports on data covering 6 months of television food advertising targeting children. Six out of seven of the Nation's commercial television networks participated (response rate = 85.7%). Based on reported timings of children's programmes, prime time significantly differed ( p <0.05) between weekdays (mean = 1.89 +/- 0.18 hr) and weekends (mean = 4.61 +/- 0.33 hr). The increased trend during weekends, school vacation and Ramadhan was evident. Over the six-month period, the mean number of food advertisements appearing per month varied greatly between television stations (C = 1104; D = 643; F = 407; B = 327; A = 59; E = 47). Food advertising also increased the most in September (n = 3158), followed by July (n = 2770), August (n = 2431), October (n = 2291), November (n = 2245) and June (n = 2211). Content analysis of advertisements indicated snacks were the highest (34.5%), followed by dairy products (20.3%), sugars and candies (13.4%), biscuits (11.2%), fast food (6.7%), breakfast cereal (6.4%), beverages (4.1%), supplements (0.9%), rice (0.6%), noodles (0.5%), bread (0.3%), miscellaneous and processed foods (0.2%). Paradoxically, we found that the frequency of snack food advertised during children's prime time was 5 times more than fast foods. The sodium content (mean = 620 mg per 100g) of these snack foods was found to be highest.

Matched MeSH terms: Health Promotion
Fulltext Patterns of smoking among adolescents in Malaysia and Thailand: findings from the International Tobacco Control Southeast Asia survey

Hammond D, Kin F, Prohmmo A, Kungskulniti N, Lian TY, Sharma SK, et al.

Asia Pac J Public Health, 2008;20(3):193-203.
PMID: 19124313 DOI: 10.1177/1010539508317572

At present, 70% of the world's 1.1 billion smokers are in developing countries, with over 50% in Asia alone. The current study examined patterns of youth smoking in Thailand and Malaysia. Respondents were 2002 youths between the ages of 13 and 17 from Thailand (n = 1000) and Malaysia (n = 1002). Respondents were selected using a multistage cluster sampling design and surveyed between January 2005 and March 2005. Approximately 3% of youth between the ages of 13 and 17 were current smokers, with an additional 10% to 12% reporting experimental smoking. Males were between 7 and 15 times more likely to report smoking behavior than females. Less than 1% of females respondents in either country met the criteria for current smoking, and less than 5% met the criteria for experimental smoking. In contrast, more than 50% Thai males and approximately one-third of Malaysian males aged 17 met the criteria for either experimental or current smoking.

Matched MeSH terms: Health Promotion*
Fulltext Community participatory approach: an important option in cardiovascular diseases prevention and control

Khalib Abdul Latiff

Malaysian Journal of Community Health, 2008;14(2):19-23.
MyJurnal

Introduction : Despite the number of information generated by researchers, cardiovascular diseases problem has not clearly declined and perhaps in certain situation it is gradually increasing, affecting people who are previously at low risk. There is a tendency to believe that favourable outcomes can always be expected once intervention activities, like exercise promotion, are carried out, but practical experience gives rise to serious doubt.
Methods : A greater understanding of the socialization mechanisms operating in the adoption of physical activity in CVD control and allow specific exercise prescriptions for communitybased prevention and control is important. This paper highlighted the author’s feeling about controlling chronic diseases by mean of community intervention.
Results : This analysis has strongly believed that the important impetus of any community intervention approach should be oriented in the form of “from people to people”.
Conclusion : More emphasis needs to be placed on effective management and parameters for assessment of its management success.

Matched MeSH terms: Health Promotion
Fulltext Is there a need for a hospital based smoking cessation programme in Malaysia?

NoorZurani MHR, Mohammad Hussain H

Malaysian Journal of Psychiatry, 2008;17(2):1-4.
MyJurnal

Smoking cessation programmes have been available for almost 2 decades in Malaysia. However the programmes have mainly focussed on outpatient primary care settings. More attention is needed to address and treat smokers presenting to hospitals with acute and chronic medical illness as hospitals provide good settings to implement smoking cessation intervention. For instance, a tobacco related medical illness may boosts a smoker\'s motivation to stop, especially when the smoker perceives smoking as the cause of his illness and understands the gains achieved by smoking cessation. Besides bringing a smoker in contact with health personnel who may offer assistance to a smoker to help him stop smoking, a hospital stay also provide an opportunity for the health carer to initiate and practice the government policy of no smoking in the hospitals. This article addresses the importance of having a hospital-based smoking cessation programme for the Malaysian hospitals.

Matched MeSH terms: Health Promotion
Fulltext The Malaysian health reform in primary health care services

Aniza I, Jamsiah M, Amin SA, Ali M, Munizam AM

Malaysian Journal of Community Health, 2008;14(2):1-10.
MyJurnal

Introduction : Family Health Development Division is one of the earliest divisions in Public Health Department, Ministry of Health Malaysia. The division has progressed each year with the extension and expansion of the scopes of services since the establishment of Maternal and Child Health Unit in 1956. The services currently include school children, adolescent, adult and elderly health and also known as life-course perspective: from womb to tomb.
Objectives : The objective is to elaborate and explain the reformation of primary health care services implemented in the past and present.
Methods : The methodology applied is compilation, data review and comparison from annual report, action plan report, articles, speeches, specialists and stake holder view.
Results : The focus of Primary Health Care Service is covering health promotion, disease prevention, early detection and treatment, acute disease care, disease limitation and rehabilitation, clinical support services and teleprimary care. The reformation is caused by factors such as globalization, modernization, growth of health market, emergence and re-emergence of diseases, and development of medical technology. Three health fields that have underwent and under going reformation are concept and wellness practise in primary healthcare, primary healthcare clinical support services development and primary healthcare informatics development. The outcome of these reformations is the increment of service quality and outstanding services for patients and health staffs.
Conclusion : Health reformation in primary healthcare is greatly needed to give excellent services for primary health care for today and future.

Matched MeSH terms: Health Promotion
Fulltext Tobacco use, knowledge and attitude among Malaysians age 18 and above

Lim KH, Sumarni MG, Amal NM, Hanjeet K, Wan Rozita WM, Norhamimah A

Trop Biomed, 2009 Apr;26(1):92-9.
PMID: 19696733 MyJurnal

This study aims to determine the level of knowledge and to understand their attitude towards smoking and secondly to determine how sociodemographic background, smoking status and knowledge on the health risks of smoking contribute toward the development of such attitude. A total of 10,545 respondents age 18 years and above across Malaysia were interviewed. Results indicated that level of knowledge and attitude varied by gender, education level, smoking status, age, ethnicity and smoker category. Smokers' low education, poor knowledge on the dangers of smoking and being males had more positive or greater impact on their attitudes towards smoking. Formulation and implementation of a holistic programme aimed at increasing knowledge and attitude change that accounts for sociodemographic background of the population is recommended in order to bring down smoking rates and thus reduce smoking related health problems in this country.

Matched MeSH terms: Health Promotion/methods
A public health pharmacy course at a Malaysian pharmacy school

Hassali MA, Shafie AA, Awaisu A, Mohamed Ibrahim MI, Ahmed SI

Am J Pharm Educ, 2009 Nov 12;73(7):136.
PMID: 19960093

OBJECTIVES: To develop and implement a new course on public health into the bachelor of pharmacy (BPharm) curriculum in Malaysia.
DESIGN: A required 2-credit-hour course was designed to provide an overview of public health pharmacy roles and the behavioral aspects of human healthcare issues. Graded activities included nursing home visits, in-class quizzes, mini-projects, and poster sessions, and a comprehensive final examination.
ASSESSMENT: The majority of the students performed well on the class activities and 93 (71.5%) of the 130 students enrolled received a grade of B or higher. A Web-based survey was administered at the end of the semester and 90% of students indicated that they had benefited from the course and were glad that it was offered. The majority of students agreed that the course made an impact in preparing them for their future role as pharmacists and expanded their understanding of the public health roles of a pharmacist.
CONCLUSIONS: A public health pharmacy course was successfully designed and implemented in the BPharm curriculum. This study highlighted the feasibilities of introducing courses that are of global relevance into a Malaysian pharmacy curriculum. The findings from the students' evaluation suggest the needs to incorporate a similar course in all pharmacy schools in the country and will be used as a guide to improve the contents and methods of delivery of the course at our school.

Matched MeSH terms: Health Promotion
Choosing health, constrained choices

Chee Khoon Chan

Glob Health Promot, 2009 Dec;16(4):54-7.
PMID: 20028669 DOI: 10.1177/1757975909348131

In parallel with the neo-liberal retrenchment of the welfarist state, an increasing emphasis on the responsibility of individuals in managing their own affairs and their well-being has been evident. In the health arena for instance, this was a major theme permeating the UK government's White Paper Choosing Health: Making Healthy Choices Easier (2004), which appealed to an ethos of autonomy and self-actualization through activity and consumption which merited esteem. As a counterpoint to this growing trend of informed responsibilization, constrained choices (constrained agency) provides a useful framework for a judicious balance and sense of proportion between an individual behavioural focus and a focus on societal, systemic, and structural determinants of health and well-being. Constrained choices is also a conceptual bridge between responsibilization and population health which could be further developed within an integrative biosocial perspective one might refer to as the social ecology of health and disease.

Matched MeSH terms: Health Promotion*
An action research on promotion of healthy ageing and risk reduction of chronic disease: a need assessment study among rural elderly Malays, care givers and health professionals

Nur Asyura Adznam S, Shahar S, Rahman SA, Yusof NA, Arshad F, Yassin Z, et al.

J Nutr Health Aging, 2009 Dec;13(10):925-30.
PMID: 19924355

OBJECTIVE: Prior to the development of a healthy ageing and risk reduction of chronic diseases intervention package for older people in Malaysia, a need assessment study was conducted to identify nutritional knowledge status and information needs, as part of an action research process.
DESIGN: A cross sectional study was conducted among 267 elderly people, 54 care givers and 66 health professionals in two rural areas of Peninsular of Malaysia (i.e Sabak Bernam, Selangor and Kuala Pilah, Negeri Sembilan). Information on nutritional knowledge was obtained from an interview based questionnaire for older subjects and caregiver and through self administered questionnaire from the health professionals. Anthropometric and functional measurements were also conducted among elderly subjects.
RESULTS: It was found that the elderly subjects had poor nutritional knowledge with 43.8% of them classified as having unsatisfactory nutritional knowledge, followed by moderately satisfactory (33.7%), very unsatisfactory (15.7%) and good (6.7%). Talks, counselling sessions with health professionals and electronic media such as television and radio were the most preferred nutrition education sources among elderly subjects and their care givers. The majority of health professionals studied (98.5%) had good nutritional knowledge. Although most of them (93.6%) were involved in management of the elderly, only 45.5% incorporated nutritional information component in this activity. Most of the health professionals used the guidelines for management of elderly patients (63.6%). However, nutritional knowledge was very minimal in these guidelines. Multiple regression analysis indicated that 'level education', involvement in 'social activities', presence of 'hearing problems', the Instrumental Activities of Daily Living (IADL) score, having previous 'nutritional information' and 'participation in healthy eating programme' were the major predictors of nutritional knowledge score among elderly subjects.
CONCLUSION: Based on the above findings it is thus, imperative that an appropriate nutritional intervention package and programme be developed so as to help improve nutritional knowledge and subsequently the nutritional status of the rural elderly Malays.

Matched MeSH terms: Health Promotion/organization & administration
Fulltext Association of major dietary patterns with obesity risk among Mongolian men and women

Dugee O, Khor GL, Lye MS, Luvsannyam L, Janchiv O, Jamyan B, et al.

Asia Pac J Clin Nutr, 2009;18(3):433-40.
PMID: 19786392

Mongolia is experiencing changes in its unique nomadic lifestyle and dietary habits in the last two decades with accompanying increase in obesity rate. The dietary pattern approach, which investigates the overall diet in relation to obesity risks, has become appealing in nutrition epidemiology. The aim of this study was to identify major dietary patterns of the Mongolian adults in relation to the risk of having obesity. Dietary intake of a total 418 adults aged ? 25 years was assessed by using a food frequency questionnaire with 68 items. An exploratory factor analysis resulted in three dietary patterns: transitional high in processed meat and potato, traditional rich in whole milk, fats and oils and healthy with greater intake of whole grains, mixed vegetables and fruits. Individuals in the upper quintile of the transitional pattern had significantly greater risk of obesity (BMI > or =25 kg/m2: OR=2.47; 95% CI=1.04-5.86) while subjects in the highest quintile of the healthy dietary pattern were found to have significantly decreased risk of obesity (OR: 0.49; 95% CI=0.25-0.95). Men in the highest quintile of the transitional pattern had greater risk of abdominal obesity WC > or =90 cm: OR= 4.08; 95% CI=1.11-14.97) than those in the lowest quintile. Women in the top quintile of the traditional pattern had a greater odds of having abdominal obesity (WC > or =80 cm: OR=4.59; 95% CI=1.58-13.30) than those in the lowest quintile. The study suggests that public health efforts be targeted at adults in Mongolia to address the undesirable aspects of the transitional and the traditional dietary patterns.

Matched MeSH terms: Health Promotion
Fulltext Public health preparedness and response to flood disaster in Johore, Malaysia : challenges and lessons learned

Arbaiah, O., Daud, A.R., Surinah, A., Noorhaida, U., Shaharom, N.A.M.C.D., Rahim, A.

Malaysian Journal of Community Health, 2009;15(3):126-131.
MyJurnal

Introduction : The 2006 -2007 flood in Johore which displaced more than 312,386 residents of the state was an extraordinary event and tested everyone preparedness. The disaster caused massive material, economic and environmental losses exceeded the state and local community capacity, forcing them seeks help from other states. Needs assessment, effectiveness of health services as well as leadership and nongovernment organization involvement were evaluated and constitute lessons learnt from the experiences.
Methodology : This is a descriptive review of the Johore flood. The review was based on literature search using established data and published reports of previous disasters. Discussion will focus on the 4 S’s of the surge capacity that is Structure, Staffing, Supplies and System (policies & procedures). Result : Structure- although 49 or 14% of health facilities in the state were affected by the flood, health services continued to be given. Majority of the relief centers were schools with better facilities. Funding for repairs obtained early approval as estimation of damages was timely applied. Temporary isolation centers for the conjunctivitis outbreak was appropriate implemented. Staffing- Leadership was assumed by the Johore State Health Department, the strongest and most prepared health sector. Needs assessment resulted in additional staff being deployed from other states allowing local staff to have their break from work as well as personal stress. Local staff became multi-skilled players. Training in disaster preparedness has to be of utmost priority to support such needs. Supplies- Personnel protective and pest control equipment, and medical supplies were adequately supplied. The laboratory services were well prepared. Pamphlets, posters, buntings and banners were distributed including five new health promotion materials. System- Flood disaster plan of action was well in place resulting in efficient management of the operating rooms, data management, coordination of services and disease surveillance through early warning system.
Conclusion : Public health preparedness is a matter of good governance and management based on evidence and experience. There is a need for a permanent and stable program for the Ministry of Health to prepare and coordinate the response to all disasters.

Matched MeSH terms: Health Promotion
Fulltext Pharmaceutical service during flood in Johore State

Maimunah, W., Kwong, CS, Siti Rozana, M.S., Shahariah, A.

Malaysian Journal of Community Health, 2009;15(3):132-137.
MyJurnal

Objective : This scientific writing is meant for describing the problems faced by pharmacy staffs during heavy flood situations in Johore and the actions to be taken for solving these problems.
Methodology : This finding is in accordance to the observations, experiences and interview of staffs (through questionnaires), who are involved directly and indirectly in preparations of emergency during flood. Efficiency of pharmaceutical services provided during flood is evaluated.
Result : Several problems were identified when providing pharmaceutical services, such as purchasing and supplying of items, pre-packing, preparing drug charts, visit to relief centers, post-flood health campaign, and doctors from NGOs prescibing medicines out of MOH drug formulary. During the period of flood, usage of drug and non-drug items increases drastically resulting in the current stock in store were not sufficient to compensate for the high demand. Moreover, inaccessibility of certain roads in districts such as Segamat and Kota Tinggi, aggravated and worsen the problems of obtaining goods from suppliers. Workload of pharmacy staffs increased especially in activities such as pre-packing and preparing drug charts due to shortage of manpower.
Conclusion : Even though workload increased drastically during flood, pharmaceutical services provided by the state pharmacy are still able to maintain good quality services to cater for the need of healthcare professionals and patients. Throughout the flood period, all the difficulties and hurdles faced by us had been solved; due to the cooperation from other agencies. Besides, by writing this article, a disaster preparedness guideline is produced for the purpose of improving management of future disasters.

Matched MeSH terms: Health Promotion
Fulltext Tahap pengetahuan keselamatan dan kesihatan pekerjaan di kalangan pekerja di makmal perubatan di Lembah Klang

Anuar, I., Zahedi, F., Kadir, A., Mokhtar, A.B.

Malaysian Journal of Community Health, 2009;15(2):35-42.
MyJurnal

Background : A safety culture practice through prevention needs skillful, knowledgeable and competencies workers. The effectiveness of occupational safety and health programme implementation needs the knowledge related to Occupational Safety and Health Acts, 1994 (OSHA 1994) and its regulations.
Objective : This study was to determine the level of knowledge and awareness towards Occupational Safety and Health (OSH) aspects among workers in medical laboratory.
Methodology : A cross-sectional study was carried out on 34 medical laboratories in which 17 were from private and another 17 laboratories were from public sectors. It consists of 112 medical laboratory disciplines. Data were obtained using self-administered questionnaire consisting of 33 questions related to Occupational Safety and Health (OSH). Each question was coded “know” and “do not know” and respondents were needed to state their understanding towards each OSH issue tendered.
Results : Respondent’s level of knowledge was analyzed according to socio-demography and socioeconomic factors. OSH level of knowledge among medical laboratory workers showed that there are significant differences (p0.05) in OSH knowledge according to between sex, marital status, income and services sectors among workers in medical laboratories. Only about 60.5% of respondents knew the existence of OSHA 1994, whereas those who knew about OSHA 1994 regulations were below than 50.0% from overall respondents.
Conclusion : Promotion and practices of dynamic safety culture through prevention needs high knowledge of OSH.

Matched MeSH terms: Health Promotion
Fulltext Food variety score is associated with dual burden of malnutrition in Orang Asli (Malaysian indigenous peoples) households: implications for health promotion

Saibul N, Shariff ZM, Lin KG, Kandiah M, Ghani NA, Rahman HA

Asia Pac J Clin Nutr, 2009;18(3):412-22.
PMID: 19786390

This paper reports on the presence of dual burden households in Orang Asli (OA, indigenous people) communities and its associated factors. A total of 182 OA households in two districts in Selangor with the required criteria (182 non-pregnant women of child bearing age and 284 children aged 2-9 years old) participated in the study. Height and weight of both women and children were measured. Energy intake and food variety score (FVS) were determined using three 24-hour diet recalls. While 58% were underweight and 64% of the children were stunted, the prevalence of overweight and obesity in women were 31% and 20% respectively. The percentage of dual burden households (overweight mother/underweight child) was 25.8% while 14.8% households had normal weight mother/normal weight child. The mean food variety score (FVS) was similar for women (7.0+/-2.1) and children (6.9+/-1.9). Dual burden households were associated with women's employment status (OR: 3.18, 95% CI: 2.65-5.66), FVS of children (OR: 0.71, 95% CI: 0.51-0.95) and FVS of women (OR: 1.39, 95% CI: 1.02- 1.89). The FVS of children (OR: 0.49, 95% CI: 0.25-0.89) and women (OR: 1.92, 95% CI: 1.64-2.77) remained significant even when dual burden households were compared to only households with normal weight mother/normal weight child. In these OA communities, food variety may predict a healthier diet in children, but may increase the risk of overweight and obesity in adults. Efforts to address households with dual burden malnutrition should consider promotion of healthy diets and lifestyle for all members.

Matched MeSH terms: Health Promotion*
Maternal mortality in developing countries: challenges in scaling-up priority interventions

Prata N, Passano P, Sreenivas A, Gerdts CE

Womens Health (Lond), 2010 Mar;6(2):311-27.
PMID: 20187734 DOI: 10.2217/whe.10.8

Although maternal mortality is a significant global health issue, achievements in mortality decline to date have been inadequate. A review of the interventions targeted at maternal mortality reduction demonstrates that most developing countries face tremendous challenges in the implementation of these interventions, including the availability of unreliable data and the shortage in human and financial resources, as well as limited political commitment. Examples from developing countries, such as Sri Lanka, Malaysia and Honduras, demonstrate that maternal mortality will decline when appropriate strategies are in place. Such achievable strategies need to include redoubled commitments on the part of local, national and global political bodies, concrete investments in high-yield and cost-effective interventions and the delegation of some clinical tasks from higher-level healthcare providers to mid- or lower-level healthcare providers, as well as improved health-management information systems.

Matched MeSH terms: Health Promotion/organization & administration*

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